Effects of Voluven pre-perfusion strategy extracorporeal circulation on the coagulation function and clinical outcome of infants after cardiac surgery

doi:10.3969/j.issn.1672-5301.2017.12.016

Abstract：Objective To study the effect of preoperative Voluven perfusion strategy on the coagulation function and clinical outcome of infants after cardiopulmonary bypass,and to evaluate whether it could be safe for infants and young children.To provide a basis for clinical savings in plasma.Methods From February 2017 to May 2017,80 children with congenital heart disease were selected.Children were randomly divided into plasma group and Voluven group,each group included 40 cases.Sex,age,body weight,disease,surgical incision and preoperative coagulation function was counted.We did data statistic on the preoperative and postoperative plasma colloid osmotic pressure,preoperative,intraoperative,after modified ultrafiltration,and the hematocrit in dis-charge,Preoperative and postoperative platelet count,Preoperative and postoperative parameters of thromboelatography;postoperative 24 h drainage,ventilator use time,length of stay in intense care room,length of stay in hospital,postoperative plasma use rate,postoperative hematopoietic cell use rate,postoperative prothrombin complex use rate.Results Children in two groups were healed and discharged from hospital.The postoperative colloid osmotic pressure[(14.76±1.33)mm Hg vs (14.90±1.02)mm Hg],coagulation reaction time(R)[(8.23±2.28)min vs (7.96±3.00)min],blood clot formation time(K)[(4.65±2.27)min vs (3.74±2.01)min],image opening angle(Angle)[(44.23±9.12)° vs (48.03±8.46)°],coagulation index(CI)[(-6.08±3.22)mm vs (-4.78±2.91)mm],PLT count[(289.15±102.94)×109 vs (300.00±85.66)×109] were all have significant difference between the two groups (P＞0.05).The postoperative 24 h drainage [(23.00t7.90)ml vs (20.75±7.21)ml],plasma use rate [(10％) vs (7.5％)],ventilator use time [(19.31±22.59)h vs (22.45±25.92)h],prothrombin complex use rate [(5％) vs (7.5％)],hospital stay time [(14.27±4.75)d vs (13.77t4.82)d] were have no significant difference between the two groups (P＞0.05).Conclusion The use of Voluven instead of plasma for infants and young children after cardiopulmonary bypass did not produce significant adverse effects on the clinical outcome,and this strategy did not increase postoperative complications in children.Infants and young children with congenital heart surgery can safely use this strategy for cardiopulmonary bypass pre-perfusion.